Term
| What 4 things does the Oxygen content of blood depend on? |
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Definition
Hemoglobin concentration
Binding coefficient of Oxygen for hemoglobin
Percent saturation of hemoglobin
Quantity of Oxygen dissolved in the plasma |
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Term
True or False:
Normally, blood gives up only 25% of its oxygen |
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Definition
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Term
| Increased _____ for oxygen and Decreased ____ of oxygen results in greater extraction of Oxygen from hemoglobin from the oxygen dissociation curve shifting to the right |
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Definition
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Term
| When there is not enough Oxygen and the body goes into anaerobic metabolism and produces increased lactic acid, what does this lead to? |
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Definition
Systemic acidosis
Impaired Cardiac Performance
Decreased Perfusion
Further tissue ischemia |
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Term
| What are 2 things you should consider before transfusing RBCs? |
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Definition
Giving Oxygen
Reducing Demand (bed rest) |
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Term
| Generally, 1 unit will raise the average adult hemoglobin by how much? |
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Definition
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Term
| Generally, 1 unit will raise the average adult hematocrit by how much? |
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Definition
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Term
True or False:
All information must be checked again at bedside by 2 nurses and signed |
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Definition
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Term
| If not used, the unit MUST be RETURNED to the BB within how many minutes or it must be tossed? |
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Definition
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Term
| Can't run blood with any other susbstance except what? |
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Definition
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Term
| Why can't you run blood with any other substance than 0.9% Saline? |
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Definition
Other substances or drugs can:
Hemolyze blood
Change pH
Ringers can activate clotting |
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Term
| What is used to control infusion rate? |
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Definition
| Electromechanical diffusion devices |
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Term
| What do you do in surgery of trauma to prevent cardiac arrest associated with the infusion of cold blood or if patient has cold antibody? |
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Definition
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Term
True or False:
Blood too warm can cause hemolysis |
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Definition
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Term
| Should you use a microwave to warm up blood? |
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Definition
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Term
| At what time do most serious problems show up? |
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Definition
| within the first few minutes |
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Term
| Adverse reactions must be documented and reported to whom? |
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Definition
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Term
| What type of blood do you give in an emergency setting if you do not the blood type? |
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Definition
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Term
| What Rh type of blood do you give in an emergency setting if it is a woman of child bearing age? |
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Definition
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Term
True or False:
It is better with a young female to switch ABO group than give Rh + blood |
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Definition
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Term
| For a A negative woman what is better to give her: O negative or A positive? |
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Definition
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Term
| If it is an emergency situation and you do not know their blood type and it is a male patient and there is not enough negative blood to give for the whole transfusion what do you give? |
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Definition
| Rh + right away to save Rh = for other patients |
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Term
| What is one of the most transfused patient groups? |
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Definition
| Neonatal - birth to 4 months |
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Term
| For Neonatal what do you exchange transfusion for to prevent kernicterus? |
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Definition
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Term
| For HDN what can exchange do? |
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Definition
Lower bilirubin
remove ABY coated cells
Free Maternal ABY |
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Term
True or False:
Blood must be compatible with maternal IgG ABY as well as ABO and Rh of infant |
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Definition
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Term
| What type of blood should you use for Neonatal? |
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Definition
| Fresh pooled (less than 7 days) to have more 2,3-DPG and less Potassium |
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Term
| Use CPDA-1 RBCs resuspended in compatible FFP to a final hematocrit of what? |
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Definition
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Term
| Additive solutions such as adenine can be ______ to immature kidneys |
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Definition
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Term
| 90% of neonatal transfusions are for what? |
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Definition
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Term
| You transfuse for neonatal when what percent reduction in volume occurs |
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Definition
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Term
| Babies with RDS, keep hematocrit as what percent to provide greater oxygen transport since lungs aren't working |
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Definition
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Term
True or False:
Do NOT transfuse when normal infants drop hematocrit unless they have symptoms of RDS or HDN |
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Definition
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Term
| If on original testing the infant does NOT possess alloantibodies from mom, what type of blood can be used for up to 4 months of age? |
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Definition
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Term
| What type of blood is given for premature infants or for inutero? |
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Definition
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Term
True or False:
CMV is much more serious in babies and can cause death |
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Definition
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Term
| With Neonatal GVHD what type of blood is used? |
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Definition
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Term
| Rh negative moms have their IAT repeated and are given RHIG at how many weeks? |
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Definition
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Term
| Do you perform a titer on the Rh negative mom if the IAT is positive or negative? |
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Definition
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Term
| What type of transfusion can you give if HDN is detected and the baby is too immature to deliver |
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Definition
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Term
| One uses an ultrasound to get into the umbilical cord because what type of access is often a problem? |
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Definition
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Term
| Define Massive Transfusion |
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Definition
| One or more blood volumes in 24 hours |
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Term
| For massive transfusions what type of blood do you use? |
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Definition
| Whole blood and colloid solutions |
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Term
True or False:
Many clinical signs previously ascribed to massive transfusion are really tissue trauma or hypoperfusion |
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Definition
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Term
True or False:
The pH of stored blood is lower and has more potassium |
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Definition
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Term
True or False:
Massive transfusion does not generally cause acidemia or hyperkalemia |
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Definition
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Term
True or False:
Large volume of refrigerated blood can cause a risk for cardiac toxicity due to hypothermia |
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Definition
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Term
| Poor oxygenatiion is due to what? |
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Definition
| Inadequate blood flow and and blood pressure |
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Term
| Stored blood has less of what than fresh blood? |
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Definition
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Term
| Transfused RBCs regenerate what percentage of normal 2,3-DPG levels in 3-8 hours |
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Definition
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Term
| Transfused RBCs regenerate 50% of normal 2,3-DPG in how many hours? |
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Definition
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Term
True or False:
It is best not to transfuse Autoimmune hemolytic anemia patients if die to serologic difficulties are encountered |
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Definition
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Term
| If die to serologic difficulties are encountered for an Autoimmune hemolytic anemia patient, what must be determined? |
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Definition
| If there are any underlying allos |
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Term
| Define Hypertransfusion in relation to Sickle Cell patients |
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Definition
| Blood given frequently to maintain hematocrit at 30% and to keep Hemoglobin S at about 30% |
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Term
True or False:
Because Sickle Cell patients get so many transfusions, it is best to phenotype and if possible give AGN compatible RBCs to prevent alloimmunization |
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Definition
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Term
| What should you do to the RBCs to be given to sickle cell patients to prevent HLA ABYs and subsequent febrile transfusion reactions? |
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Definition
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Term
| What should you use for patients with Thalassemia to lengthen the time between transfusions? |
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Definition
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Term
| What is the concern about for patients with Thalassemia? |
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Definition
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